Although the cemetery next to St. Philomena church holds a number of tombstones, fewer than 1,000 of the 8,000 patients who died at Kalaupapa have marked graves. A memorial that will include as many of the previous residents' names as possible is still in the planning stages, after a Senate bill to create one was approved by President Obama in 2009.

Photo: Jeanne Cooper, Special To SFGate

Although the cemetery next to St. Philomena church holds a number...

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A dark stone cross marks the original gravesite of St. Damien next to the church he largely built himself, St. Philomena, in Kalawao side on Molokai's Kalaupapa peninsula. During Mother Marianne Cope's time, most of the settlement moved to the western side, also known as Kalaupapa.

Photo: Jeanne Cooper, Special To SFGate

A dark stone cross marks the original gravesite of St. Damien next...

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Ruins of a number of structures dot the eerie landscape of Molokai's Kalaupapa peninsula, now home to just a handful of patients with Hansen's disease, formerly known as leprosy.

Photo: Jeanne Cooper, Special To SFGate

Ruins of a number of structures dot the eerie landscape of...

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A portrait of a young Mother Marianne Cope, who came to Kalaupapa in her early 50s, hangs in St. Francis Catholic Church, which was built in the Molokai settlement during her nearly 30 years of service there.

Photo: Jeanne Cooper, Special To SFGate

A portrait of a young Mother Marianne Cope, who came to Kalaupapa...

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The grave of Mother Marianne Cope, who never contracted Hansen's disease during her 29 years of service in Kalaupapa, is one of the first stops on the itinerary of Damien Tours. Run by the family of a late patient, the guided tours are the only way casual visitors can explore the former place of exile.

Photo: Jeanne Cooper, Special To SFGate

The grave of Mother Marianne Cope, who never contracted Hansen's...

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Not all of Hawaii's tributes to Mother Marianne Cope and St. Damien are on Molokai this stained glass window is in the Star of the Sea painted church in Kalapana, built by another Belgian priest on the island of Hawaii.

Photo: Jeanne Cooper, Special To SFGate

Not all of Hawaii's tributes to Mother Marianne Cope and St. Damien...

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Mother Marianne Cope stands next to the body of St. Damien in 1889, several months after arriving in Kalaupapa. She had also cared for him three years earlier, when he visited Oahu following his diagnosis with leprosy, now called Hansen's disease. This vintage photo hangs inside the parish hall of St. Francis church in Kalaupapa.

Photo: Jeanne Cooper, Special To SFGate

Mother Marianne Cope stands next to the body of St. Damien in 1889,...

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The oceanfront Hula Shores restaurant at Hotel Molokai, the only hotel lodgings left on the island, has been closed since a fire in June, but renovations are due to begin in January. The bar remains open, with a limited menu expected to be available within a few weeks, according to the Molokai Dispatch.

Photo: Jeanne Cooper, Special To SFGate

The oceanfront Hula Shores restaurant at Hotel Molokai, the only...

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Spoons created for blind patients in the former Kalaupapa infirmary are on display at the National Park Service's small museum on the remote peninsula.

Photo: Jeanne Cooper, Special To SFGate

Spoons created for blind patients in the former Kalaupapa infirmary...

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A tour guide with Damien Tours shares the history of Mother Marianne Cope at her gravesite in Kalaupapa. On Sunday, the German-born nun from Syracuse, N.Y., will join St. Damien in being canonized for her work at the former place of exile for patients with Hansen's disease, once known as leprosy.

Photo: Jeanne Cooper, Special To SFGate

A tour guide with Damien Tours shares the history of Mother...

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Journalist Pamela Young (left) helped Makia Malo compile his stories of growing up in Kalaupapa after being diagnosed with Hansen's disease as a young boy. Those tales and some of his poems appear in the newly published "My Name Is Makia: A Memoir of Kalaupapa."

Photo: Dawn Sakamoto

Journalist Pamela Young (left) helped Makia Malo compile his...

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The recently published "My Name Is Makia: A Memoir of Kalaupapa" includes the stories and poetry of Makia Malo, who was sent to the settlement on Molokai as a young boy after being diagnosed with Hansen's disease.

Photo: Watermark Publishing

The recently published "My Name Is Makia: A Memoir of Kalaupapa"...

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Dennis Kamakahi and Stephen Inglis' Kalaupapa-themed album "Waimaka Helelei" won the 2012 Na Hoku Hanohano award for best slack-key album of the year. Both have spent significant time with people with Hansen's disease at Hale Mohalu on Oahu and Kalaupapa on Molokai.

Kalaupapa, for more than a century a place of exile for people with Hansen's disease (as leprosy is called today), is a potent symbol of Molokai in general: physically beautiful, relatively inaccessible, understandably insular and frequently misunderstood. But new lights are shining on the people and places of this remote peninsula, now a national historical park, which may bring greater understanding — as well as more visitors — to the lonely isle.

A new saint

It seems like everyone's heard of Father Damien, the 19th century Belgian priest whose devoted service to Kalaupapa patients eventually led to his death from Hansen's disease — and elevation to sainthood in 2009. Yet few outside of the Roman Catholic Church and Hawaii are as familiar with Mother Marianne Cope, the German-born nun and nurse from Syracuse, N.Y., who spent nearly 30 years serving the people of Kalaupapa. That should change with her canonization in Rome on Sunday, Oct. 21.

She had already been honored by King Kalakaua and Queen Kapi' olani for building Maui's first general hospital and tending to the sick on Oahu before she answered a call to Kalaupapa, arriving a few months before Damien's death in 1889. She cared for the dying priest, and promised she would continue his work — without her or any of her fellow Franciscan nuns contracting Hansen's disease. Known in Hawaiian as "Makuahine Meleana," Mother Marianne kept both vows, creating a home for girls and single women, rebuilding the boys' and men's home and tirelessly advocating on behalf of the patients, while maintaining sanitary protocols that prevented the spread of disease. (For more about her life and legacy, see the video produced by the Diocese of Honolulu.)

Mother Marianne died in 1918 at the age of 80 and was buried in Kalaupapa, until her beatification in 2005, when her remains were returned to the St. Anthony Convent in Syracuse. In honor of her sainthood, Catholic schools and churches in Hawaii are holding special services, presenting concerts and staging plays (see the diocesan calendar for details), with a civic and interfaith ceremony planned for 'Iolani Palace at 2 p.m. Nov. 4.

Sharing a patient's stories

As inspiring as the stories of Marianne and Damien may be, they sometimes overshadow those of the modern era — the 1866 policy of quarantine and exile to Kalaupapa continued through 1969. The recently released "My Name Is Makia: A Memoir of Kalaupapa" (Watermark Publishing) offers not only a more contemporary perspective but also an engagingly earthy tone.

With assistance from journalist Pamela Young, author Makia Malo depicts the innocence, confusion and suffering of being sent to Kalaupapa in 1947 at the age of 12, where several siblings had preceded him; his eventual release and studies at the University of Hawaii; and his personal and professional journeys since then. Malo mixes personal anecdotes and interviews with poems and tales incorporating Native Hawaiian imagery, in a voice that moves easily between Pidgin inflections, poetic English and oral storytelling.

In a poem called "Malihini" ("Newcomer"), Malo writes:

We all had a role in this drama, Playing out our parts toward an end that no one acknowledged, But, of course, all were aware of.

The days passed into weeks, into months, into years. Newcomers came after me; some younger, some older. Each passing of time marked the loss of yearning for home, To be replaced, by despair, then indifference, then acceptance ... Until finally, "I'll never leave this place, And be damned glad of it!"

Also recommended reading: "No Footprints in the Sand: A Memoir of Kalaupapa," by former patient Henry Nalaielua (Watermark Publishing, 2006.) When Nalaielua died in 2009, two dozen patients, all over the age of 67, still lived at Kalaupapa; today the number is said to be 17.

Songs of joy and pain

When slack-key guitarists and singer-songwriters Dennis Kamakahi and Stephen Inglis (a former Berkeley resident) discovered a couple years ago that they each had personal connections to Kalaupapa, including entertaining patients there, a memorable musical partnership was born. "Waimaka Helelei" ("The Falling Tear"), their joint album released last fall, contains original songs inspired by Kalaupapa and Molokai, plus two by their late friend, patient/activist Bernard Punikai'a, and the romantic "Sunset of Kalaupapa," a 1950 hit by patient Samson Kuahine, whose royalties generated funds to buy musical instruments for residents. The 28-year-old composer had never seen a sunset, though: Hansen's disease had rendered him blind.

The title track of "Waimaka Helelei," named slack key album of the year at the islands' prestigious Nā Hōkū Hanohano Awards in May, also has a surprisingly jaunty sound, despite its poignant subject matter. As composer Kamakahi explains in the liner notes and in concert:

"When I sat with a terminally ill woman patient at Kalaupapa in 1975, I saw in her deep happiness radiating from within. She had no arms, no nose, but a bright smile, and when I finished singing a song to her, she smiled and applauded with what was left of her arms, two stumps that the disease had left to her. Yet the sound of her applause was louder than the sound of thunder. I was overcome and burst into tears. She had shown me that she accepted her deformity and her soul was about to be released. She passed away that day. And so the song is a joyous one, because I knew that in the next world she would be whole again. That changed my life. There is no sadness in a place built on it. There is only hope and faith."

Remembering the dead

Although there are 14 cemeteries in Kalaupapa, reflecting different religious and cultural affiliations, approximately 7,000 of the 8,000-plus patients who died in exile here lie in unmarked graves. A group called Ka 'Ohana O Kalaupapa, "the family of Kalaupapa," formed in 2003 with the establishment of a memorial that includes their names as a primary goal. The Hawaiian name is particularly appropriate, since 90 percent of those sent here were of Native Hawaiian ancestry.

Approved by President Obama in 2009, the memorial is still in the planning stages today. A site in Kalawao, the windward side of the peninsula where some 5,000 patients — and St. Damien — lived and died, is a likely choice for the memorial. About 2,000 unmarked graves lie just outside the cemetery next to the church Damien built, St. Philomena. His own remains were disinterred in 1936 and reburied in Belgium, but in 1995 a relic of his right hand was returned to the St. Philomena graveyard.

More access for visitors

To protect the remaining patients' privacy and for safety reasons, the number of visitors to Kalaupapa has been strictly limited by a permit system (no children under the age of 16) that also requires visitors to take a guided tour with Damien Tours, operated by a former patient's family. But the difficulties and cost of getting there have also proved a natural barrier. Those who can hike up and down the arduous 2.9-mile trail with 26 switchbacks on the 1,700-foot sea cliff still need to pay $69 for the tour; taking a Kalaupapa Mule Tour instead costs $199 per person (tour included), with a maximum of 18 mules on the trail per day. The Father Damien Tours package with small-craft plane rides from Honolulu start at $298, while the mule tour company can also arrange flights from "topside" Molokai" for $229.

Fortunately, getting to and staying on Molokai — where most visitors to Kalaupapa stay — will be a little easier next year. Hawaiian Airlines announced this week it is buying two new turboprop planes, seating 44 to 50 passengers, to offer service to Molokai and Lanai in 2013. Mokulele Airlines currently flies Cessna Grand Caravans from the main airport in Hoolehua to Honolulu and Kahului, Maui, while Island Air uses Dash-8s and similar turboprops for service from Molokai to those cities and Lanai City and Kapalua, Maui.

With the closure of Molokai Ranch in 2008 and the shutdown of Kanemitsu Bakery this summer, lodging and dining options have also been limited. Yet there's a glimmer of light at the end of that tunnel, too. The ranch is planning on reopening the 144-room Kaluakoi Resort Hotel (and its 18-hole golf course) "in the near future," according to a July 29 report in the Molokai Dispatch. And Hotel Molokai, the sole inn currently operating on the island, will soon begin offering a simple menu of grilled items while its restaurant kitchen, destroyed in a fire in June, is being repaired. The renovation is expected to start in January and finish next spring, according to the Molokai Dispatch.

Jeanne Cooper is the former Chronicle Travel Editor and author of SFGate's Hawaii Insider, a blog about Hawaii travel and island culture.